‘Real-world’ health care priority setting using explicit decision criteria: a systematic review of the literature

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‘Real-world’ health care priority setting using explicit decision criteria: a systematic review of the literature Cromwell, Ian; Peacock, Stuart J; Mitton, Craig, 1972-

Abstract

Background: Health care decision making requires making resource allocation decisions among programs, services, and technologies that all compete for a finite resource pool. Methods of priority setting that use explicitly defined criteria can aid health care decision makers in arriving at funding decisions in a transparent and systematic way. The purpose of this paper is to review the published literature and examine the use of criteria-based methods in ‘real-world’ health care allocation decisions. Methods A systematic review of the published literature was conducted to find examples of ‘real-world’ priority setting exercises that used explicit criteria to guide decision-making. Results We found thirty-three examples in the peer-reviewed and grey literature, using a variety of methods and criteria. Program effectiveness, equity, affordability, cost-effectiveness, and the number of beneficiaries emerged as the most frequently-used decision criteria. The relative importance of criteria in the ‘real-world’ trials differed from the frequency in preference elicitation exercises. Neither the decision-making method used, nor the relative economic strength of the country in which the exercise took place, appeared to have a strong effect on the type of criteria chosen. Conclusions Health care decisions are made based on criteria related both to the health need of the population and the organizational context of the decision. Following issues related to effectiveness and affordability, ethical issues such as equity and accessibility are commonly identified as important criteria in health care resource allocation decisions.

Item Metadata

Title	‘Real-world’ health care priority setting using explicit decision criteria: a systematic review of the literature
Creator	Cromwell, Ian; Peacock, Stuart J; Mitton, Craig, 1972-
Contributor	Centre for Clinical Epidemiology and Evaluation
Publisher	BioMed Central
Date Issued	2015-04-17
Description	Background: Health care decision making requires making resource allocation decisions among programs, services, and technologies that all compete for a finite resource pool. Methods of priority setting that use explicitly defined criteria can aid health care decision makers in arriving at funding decisions in a transparent and systematic way. The purpose of this paper is to review the published literature and examine the use of criteria-based methods in ‘real-world’ health care allocation decisions. Methods A systematic review of the published literature was conducted to find examples of ‘real-world’ priority setting exercises that used explicit criteria to guide decision-making. Results We found thirty-three examples in the peer-reviewed and grey literature, using a variety of methods and criteria. Program effectiveness, equity, affordability, cost-effectiveness, and the number of beneficiaries emerged as the most frequently-used decision criteria. The relative importance of criteria in the ‘real-world’ trials differed from the frequency in preference elicitation exercises. Neither the decision-making method used, nor the relative economic strength of the country in which the exercise took place, appeared to have a strong effect on the type of criteria chosen. Conclusions Health care decisions are made based on criteria related both to the health need of the population and the organizational context of the decision. Following issues related to effectiveness and affordability, ethical issues such as equity and accessibility are commonly identified as important criteria in health care resource allocation decisions.
Subject	Programme budgeting and marginal analysis; Multi-criteria decision analysis; Health care priority setting; Health priorities; Health care rationing; Health care decision making; Literature review; Literature synthesis
Genre	Article
Type	Text
Language	eng
Date Available	2015-12-17
Provider	Vancouver : University of British Columbia Library
Rights	Attribution 4.0 International (CC BY 4.0)
DOI	10.14288/1.0221337
URI	http://hdl.handle.net/2429/55883
Affiliation	Population and Public Health (SPPH), School of; Non UBC; Medicine, Faculty of
Citation	BMC Health Services Research. 2015 Apr 17;15(1):164
Publisher DOI	10.1186/s12913-015-0814-3
Peer Review Status	Reviewed
Scholarly Level	Faculty
Copyright Holder	Cromwell et al.; licensee BioMed Central.
Rights URI	http://creativecommons.org/licenses/by/4.0/
Aggregated Source Repository	DSpace

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